Changes To Medicare’s Open Enrollment

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Medicare’s Open Enrollment has begun!  Below is some useful information about the some of the changes to Medicare’s Open Enrollment. Remember you are not alone, because we are here to help you with all of your Medicare questions.

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George Litchfield

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Changes in MedicareMedicare’s annual election period will begin October 15 and changes are expected thanks to the roll-out of the Health Insurance Marketplace. Due to the new Health Insurance Marketplace, those who are eligible for Medicare should know the differences between the two government programs.

Medicare beneficiaries have the option of making changes to their healthcare plans for 2014 during this annual enrollment period that runs from October 15 to December 7. That means anyone who has original Medicare, Medicare Advantage or Part D prescription drug plans can make any changes they desire to their coverage.

Some people may run into confusion when it comes to these two government-run health insurance exchanges. A Medicare beneficiary should know they are not required to enroll in a health insurance plan from the Health Insurance Marketplace if they already have coverage under Medicare. However, they should still evaluate their Medicare plan options for the upcoming year in order to make sure their coverage meets their medical needs.

Since the new healthcare law requires individuals to have coverage, anyone who will turn 65 during the annual enrollment period for Medicare should look for plans that will give them coverage through the end of 2013 as well as a plan that will begin on January 1, 2014.

One thing to know about Medicare is that it is not a part of the Health Insurance Marketplace. If you’re covered through Medicare then you won’t be charged penalties for being under-insured according to the Affordable Care Act (ACA). Remember that Medicare’s annual open enrollment runs from October 15 to December 7 while the Health Insurance Marketplace enrollment period is from October 1, 2013 to March 31, 2014.

Medicare changes to expect

A Medicare recipient who reaches the drug donut hole will benefit from lower costs. The gap in prescription drug coverage begins when someone reaches the initial coverage limit, which is estimated to be $2,850 in 2014. Once an individual spends $4,550, catastrophic coverage begins. When a beneficiary is in the donut hole, an individual may pay for costs out of their own pocket. However, in 2014, anyone who reaches the donut hole will be given a 52.5 percent discount on brand-name drugs and a 28 percent discount on generic drugs – up from a 21 percent discount in 2013.

Those with catastrophic coverage are responsible for a co-pay of $2.55 for generic prescription or preferred multi-source drugs that cost up to $51, a 10 cent decrease from 2013. The co-pay for drugs with a retail price of up to $127 is $6.35. In 2014, beneficiaries will be required to pay a 5 percent cost-sharing fee for any drugs with a retail price more than $127.

Changes are expected to Medicare Part B premiums, which are based on a beneficiary’s income. Information on premiums for a Part B plan for the upcoming year will be available by the time Medicare’s annual enrollment period begins.

Deductibles and premiums will change for Medicare beneficiaries with a prescription drug Part D plan. The initial deductible for Part D will decrease to $310 for 2014 and monthly premiums will be $31 for a basic drug plan. Keep in mind, however, that Part D premiums are subject to the same income-based thresholds as Part B plans.